Division of Cardiovascular Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China.
J Med Syst. 2011 Apr;35(2):203-13. doi: 10.1007/s10916-009-9357-7. Epub 2009 Aug 13.
Few studies have been devoted to the exploration of the effect of clinical pathways on coronary artery diseases treated with coronary artery bypass (CAB) surgery. This study was aimed to investigate the cost and effectiveness of the clinical pathway on CAB surgery in a medical center. With a retrospective dataset in 2003-2007, 212 CAB surgery patients were included. Data of the costs and postoperative complication occurrence and length of stays were the focus and patient demographics, surgical risk indicator EuroSCORE, surgical conditions were collected. It revealed that there was differentiation across specified cost items in beating heart CAB surgery patients, but not for heart arrest CAB surgery patients with and without clinical pathways enrolled. In addition, there was no difference in postoperative complication occurrence in CAB surgery patients enrolled into clinical pathways. However, robotic beating heart CAB surgery patients enrolled clinical pathways were shown to have less postoperative ordinary ward stay than those not enrolled clinical pathways. CAB surgery patients' age and surgical risks were related to their postoperative lengths of stay to some extent.
很少有研究致力于探索临床路径对冠状动脉旁路移植术（CAB）治疗冠心病的影响。本研究旨在探讨某医学中心 CAB 手术中临床路径的成本和效果。本研究采用回顾性数据集，纳入 2003 年至 2007 年间的 212 例 CAB 手术患者。重点关注的是成本以及术后并发症发生和住院时间的数据，收集了患者人口统计学资料、手术风险指标 EuroSCORE 和手术情况。结果表明，在心脏不停跳 CAB 手术患者中，特定费用项目存在差异，但在心脏停跳 CAB 手术患者中，无论是否采用临床路径，这种差异并不存在。此外，采用临床路径的 CAB 手术患者术后并发症的发生没有差异。然而，采用临床路径的机器人心脏不停跳 CAB 手术患者的普通病房住院时间比未采用临床路径的患者短。CAB 手术患者的年龄和手术风险在一定程度上与其术后住院时间有关。
